Aortic valve replacement in sheep with a novel trileaflet mechanical heart valve prosthesis without anticoagulationCentral MessagePerspective
Background: Even after decades of intensive research, an ideal heart valve prosthesis remains elusive. Shortcomings of conventional devices include reduced durability of bioprostheses and the thrombogenicity of mechanical substitutes, necessitating anticoagulation and resulting in imperfect hemodyna...
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| Format: | Article |
| Language: | English |
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Elsevier
2021-09-01
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| Series: | JTCVS Open |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666273621001182 |
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| author | Tim Schaller, MSc Michael Scharfschwerdt, PhD Kathrin Schubert, MSc Cornelia Prinz, PhD Ulrich Lembke, PhD Hans-Hinrich Sievers, MD |
| author_facet | Tim Schaller, MSc Michael Scharfschwerdt, PhD Kathrin Schubert, MSc Cornelia Prinz, PhD Ulrich Lembke, PhD Hans-Hinrich Sievers, MD |
| author_sort | Tim Schaller, MSc |
| collection | DOAJ |
| description | Background: Even after decades of intensive research, an ideal heart valve prosthesis remains elusive. Shortcomings of conventional devices include reduced durability of bioprostheses and the thrombogenicity of mechanical substitutes, necessitating anticoagulation and resulting in imperfect hemodynamics. Here we present in vivo results of a novel mechanical heart valve prosthesis aiming for freedom from anticoagulation. Methods: Four female sheep had their aortic valves replaced using the novel mechanical heart valve (size 21 mm), with no postoperative anticoagulation treatment. This trileaflet heart valve was designed with the pivots in the systolic central flow. Hemodynamics, biochemistry, hematology, and macroscopy and microscopy were studied at 90 days in 2 sheep and at 1 year in the other 2 sheep. Results: Mean (<6 mm Hg) and peak (<10 mm Hg) aortic transvalvular gradients remained low during the study period. Aortic regurgitation was trivial, and central traces were only rarely observed. The rate of thrombotic events was very low, with none macroscopically and microscopically visible thrombotic material on the device. Biochemistry and hemotology were unchanged without hemolysis. In 3 sheep, the fibrous pannus and mitral leaflet were partially folded over the edge of the annular body. Apart from organic/inorganic deposits on the leaflets after 1 year, the ultrastructurally evaluated leaflets were similar to those of nonimplanted controls. Conclusions: The preliminary in vivo results of this novel anticoagulation-free aortic mechanical heart valve are promising with excellent hemodynamics and a very low risk of thrombotic events. |
| first_indexed | 2024-04-11T17:34:51Z |
| format | Article |
| id | doaj.art-ba221b8971d1426abe26c40500b0a7c7 |
| institution | Directory Open Access Journal |
| issn | 2666-2736 |
| language | English |
| last_indexed | 2024-04-11T17:34:51Z |
| publishDate | 2021-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JTCVS Open |
| spelling | doaj.art-ba221b8971d1426abe26c40500b0a7c72022-12-22T04:11:39ZengElsevierJTCVS Open2666-27362021-09-0177688Aortic valve replacement in sheep with a novel trileaflet mechanical heart valve prosthesis without anticoagulationCentral MessagePerspectiveTim Schaller, MSc0Michael Scharfschwerdt, PhD1Kathrin Schubert, MSc2Cornelia Prinz, PhD3Ulrich Lembke, PhD4Hans-Hinrich Sievers, MD5Department of Cardiac and Thoracic Vascular Surgery, University of Luebeck, Luebeck, Germany; Address for reprints: Tim Schaller, MSc, Department of Cardiac and Thoracic Vascular Surgery, University of Luebeck, Ratzeburger Allee 160, 23538 Luebeck, Germany.Department of Cardiac and Thoracic Vascular Surgery, University of Luebeck, Luebeck, GermanyDepartment of Cardiac and Thoracic Vascular Surgery, University of Luebeck, Luebeck, GermanyDOT GmbH, Rostock, GermanyDOT GmbH, Rostock, GermanyDepartment of Cardiac and Thoracic Vascular Surgery, University of Luebeck, Luebeck, GermanyBackground: Even after decades of intensive research, an ideal heart valve prosthesis remains elusive. Shortcomings of conventional devices include reduced durability of bioprostheses and the thrombogenicity of mechanical substitutes, necessitating anticoagulation and resulting in imperfect hemodynamics. Here we present in vivo results of a novel mechanical heart valve prosthesis aiming for freedom from anticoagulation. Methods: Four female sheep had their aortic valves replaced using the novel mechanical heart valve (size 21 mm), with no postoperative anticoagulation treatment. This trileaflet heart valve was designed with the pivots in the systolic central flow. Hemodynamics, biochemistry, hematology, and macroscopy and microscopy were studied at 90 days in 2 sheep and at 1 year in the other 2 sheep. Results: Mean (<6 mm Hg) and peak (<10 mm Hg) aortic transvalvular gradients remained low during the study period. Aortic regurgitation was trivial, and central traces were only rarely observed. The rate of thrombotic events was very low, with none macroscopically and microscopically visible thrombotic material on the device. Biochemistry and hemotology were unchanged without hemolysis. In 3 sheep, the fibrous pannus and mitral leaflet were partially folded over the edge of the annular body. Apart from organic/inorganic deposits on the leaflets after 1 year, the ultrastructurally evaluated leaflets were similar to those of nonimplanted controls. Conclusions: The preliminary in vivo results of this novel anticoagulation-free aortic mechanical heart valve are promising with excellent hemodynamics and a very low risk of thrombotic events.http://www.sciencedirect.com/science/article/pii/S2666273621001182animal studymechanical heart valveanticoagulationaortic valve replacement |
| spellingShingle | Tim Schaller, MSc Michael Scharfschwerdt, PhD Kathrin Schubert, MSc Cornelia Prinz, PhD Ulrich Lembke, PhD Hans-Hinrich Sievers, MD Aortic valve replacement in sheep with a novel trileaflet mechanical heart valve prosthesis without anticoagulationCentral MessagePerspective JTCVS Open animal study mechanical heart valve anticoagulation aortic valve replacement |
| title | Aortic valve replacement in sheep with a novel trileaflet mechanical heart valve prosthesis without anticoagulationCentral MessagePerspective |
| title_full | Aortic valve replacement in sheep with a novel trileaflet mechanical heart valve prosthesis without anticoagulationCentral MessagePerspective |
| title_fullStr | Aortic valve replacement in sheep with a novel trileaflet mechanical heart valve prosthesis without anticoagulationCentral MessagePerspective |
| title_full_unstemmed | Aortic valve replacement in sheep with a novel trileaflet mechanical heart valve prosthesis without anticoagulationCentral MessagePerspective |
| title_short | Aortic valve replacement in sheep with a novel trileaflet mechanical heart valve prosthesis without anticoagulationCentral MessagePerspective |
| title_sort | aortic valve replacement in sheep with a novel trileaflet mechanical heart valve prosthesis without anticoagulationcentral messageperspective |
| topic | animal study mechanical heart valve anticoagulation aortic valve replacement |
| url | http://www.sciencedirect.com/science/article/pii/S2666273621001182 |
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